,AFebr°uUa^i898m'}     Analysis  of  the  Gastric  Contents.  107 
Total  combined  hydrochloric  acid,  0  21  gramme  per  mille. 
Total  organic  acids  and  acid  salts,  0-51  gramme  per  mille. 
A  comparison  of  these  results  with  those  of  other  investigators 
shows  a  general  agreement,  except^  in  regard  to  two  conditions. 
These  conditions  are : 
(1)  The  total  quantity  of  gastric  contents. 
(2)  The  condition  of  the  carbohydrate  digestion  in  the  stomach. 
The  total  quantity  of  the  gastric  contents  expressed  one  hour 
after  the  ingestion  of  an  Ewald  test  breakfast  from  the  normal 
stomach  is  placed  by  most  writers  on  the  subject  of  gastric  disease 
as  lying  between  25  and  60  c.c.  (Rosenheim,  25  to  60  c.c. ;  Leo,  25 
to  60  c.c. ;  Hammerschlag,  30  to  40  c.c.).78 
I  have  been  unable  to  find  any  report  of  any  definite  sets  of 
observations  to  serve  as  a  basis  for  this  generally  accepted  state- 
ment. The  results  are  undoubtedly  taken  from  the  large  number 
of  cases  these  observers  have  examined  in  clinical  work. 
These  writers  say  further,  that  a  quantity  of  expressed  contents 
of  over  100  c.c.  in  a  given  case  is  suggestive  of  some  affection  of 
the  motility  of  the  stomach  or  of  stenosis  of  the  pylorus. 
Boas  states  in  his  text-book  that  the  total  quantity  of  the  filtrate 
upon  the  contents  obtained  one  hour  after  the  Ewald  breakfast 
averages  40  c.c.  in  the  normal  stomach.  The  normal  limits  he 
places  as  15  c.c.  each  way.79 
He  gives  as  the  basis  of  his  statement  the  results  of  the  investi- 
gation of  eight  cases. 
The  results  in  the  fifty  cases  which  I  have  investigated  are  as  fol- 
lows : 
The  total  quantity  of  the  mixed  contents  expressed  one  hour  after 
the  Ewald  test  breakfast  averaged  no  c.c. 
The  minimum  amount  was  35  c.c. 
The  maximum  amount  was  205  c.c. 
Twenty-five  cases  showed  a  quantity  of  over  100  c.c.80 
The  total  quantity  of  the  filtrate  averaged  66  c.c. 
The  minimum  was  20  c.c.  ;  the  maximum,  140  c.c. 
Eight  cases  showed  a  total  filtrate  of  100  c.c.  or  more. 
7  8  See  reference  to  Rosenheim,  Leo,  Hammerschlag,  in  last  number. 
79  Boas  :  Diagnostik,  loc.  cit. 
80  These  high  amounts  were  obtained  two  and  three  times  in  the  same  indi- 
vidual. 
